Module 10 Flashcards
Epidemiology
The investigation of how health events in a population are patterned or distributed
Purpose of Epidemiology
Purpose is to provide a basis for developing:
- prevention strategies for groups at risk
- disease control measures for affected groups
Descriptive Epidemiology
concerned with WHAT WHO WHERE and WHEN
Focuses on the frequency and distribution of states of health within a population
*focus of this class
Analytic Epidemiology
concerned with HOW and WHY
Examples of What in Descriptive Epidemiology
What is the health event
what is the disease
what is the outcome
how severe is it
Examples of Who in Descriptive Epidemiology
Who are at risk
who is ill
(person)
Examples of Where in Descriptive Epidemiology
Where did the health event occur
How widespread is the illness
(place)
Examples of When in Descriptive Epidemiology
When did the health event happen
how long did the illness last
(time)
Characteristics included in the WHO/person of descriptive epidemiology
Age, gender, ethnicity
genetic predisposition
concurrent disease
diet and exercise
risk taking behaviors such as smoking
socio economic status
marital status
education and occupation
Characteristics included in the WHERE/place of descriptive epidemiology
Presence of agents or vectors
climate and geography
population density
economic development
customs and practices of the area
medical care and access
regional crime and unemployment rates
Characteristics of the WHEN/time of descriptive epidemiology
Calendar time
time since an event
physiologic cycles
age (time since birth)
seasonality
temporal trends
Basic Measures of Descriptive Epidemiology
Counts
Ratio
Proportion
Attack Rate
Prevalence
Prevalence Rate
Counts
simplest measure to describe how many cases
ex: 20 colds occurred
Ratio
relationship between two counts, numerator is not included in the denominator
(# those that are ill, divided by [compared to] # those that are not)
ex: 1:3 ratio of sick to healthy
Proportion
relationship between two counts
numerator is included in the denominator, part of a whole
(# of those that are ill divided by everyone)
ex: 20/100
Attack Rate
Number of persons that develop a disease divided by the number of persons exposed to the causative agent (used commonly in food Bourne illness investigations or flu outbreaks)
ex: Developed/Exposed = 5 w food poisoning / 20 total exposed
*exposed includes those who developed disease
Prevalence
cases / total pop at a certain time
Number of cases of a disease or health condition divided by the total population at a particular time
Prevalence Rate
(# of cases / population at a time) x K (constant that is 1000 or 10000)
allows for comparisons between groups or regions on a certain date!!!
something may seem worse initially but the prevalence rate can reveal that is not always the case
Incidence Rate
(# of cases / population at RISK) x K at a certain time
People who die from a disease or become immune to the disease fall out of the population at risk!!!
People who die from a disease or who recover from a disease fall out of the pool of prevalent cases because they no longer are counted as having the disease
Prevalence is a function of the ____ of disease and the ____ of disease
Incidence and Duration
A town has a population of 3600.
In 2003, 400 residents of the town are diagnosed with a disease.
In 2004, 200 additional residents of the town are diagnosed with the same disease. The disease is lifelong but it is not fatal.
calculate the prevalence in 2003?
calculate the prevalence In 2004?
calculate the incidence in 2004?
K=1000
2003 - 400/3600 x 1000 = 111 per 1000
2004 - 600 / 3600 x 1000 = 167 per 1000
Incidence of 2004: 200/3200 x 1000 = 63 per 1000
Analytic Epidemiology
Focuses on the CAUSES AND ASSOCIATIONS of states of health within a population (HOW AND WHY)
Things Identified or Determined in Analytic Epidemiology
ID causative agents, characteristics of agents, geographic patterns
Determine mode of transmission, contributing factors
involves hypothesis testing
3 Essential Characteristics examined in analytic epidemiology to determine how and why are …
Agent
Host
Environment
(The epidemiological triangle)
Agent
bacteria, virus, fungi, parasite
Host
human or animal harboring agent
Environment
physical, biological, social, and cultural factors facilitating the transmission of the agent from host to host
Early influence on epidemiology came from….
religion
Hippocrates and Epidemiology
first looked at health and disease from environmental and behavior perspectives
Miasma Theory
poisoning from foul vapors
Edward Jenner and Epidemiology
“Father of Immunology”
1798
Demonstrated small pox vaccination effectiveness
Germ Theory
microorganisms cause disease
John Snow and Epidemiology
1850
ID source of cholera epidemic to contaminated well in london
Florence Nightingale and Epidemiology
1850s
examined and tracked environmental conditions to recovery rates of soldiers in the crimean war
Chronic Disease Epidemiology
outcomes related to exposure
modifying behavior can control risk factors
Human Genome Project
New bio medical technologies can examine genetic risks
3 Important Triumphs in Epidemiology
- Small pox eradication thru vaccinations in 1967 to 1980 when it was declared dead by WHO
- cig smoking found to be major lung cancer, emphysema, and CV disease cause 1951-1963
- ID of auto immune deficiency syndrome (AIDS) and predicted that cause from STI. Development of prevent measures before the virus was ID’ed - 1981-1983
5 Important Epidemiologic Models
- Epidemiologic Triangle
- Wheel Model
- Web of Causation
- Chain of Infection
- Stages of Disease (natural history of disease)
Epidemiologic Triangle
most simple epidemi model
Factors that influence health status are:
- intrinsic Factors (host factors)
- Extrinsic factors (agent and environment)
The epidemiologic triangle occurs …
over time
Host Factors
Intrinsic factors that are the hosts ability to resist a particular infectious disease causing agent (the body forms antibodies that react with a foreign antigen and makes them harmless)
Examples of Host Factors
Genetic Susceptibility
Immutable characteristics: age, gender, race, sex
Acquired characteristics: immunological status
lifestyle factors
immunity status